Increased use of higher-cost medicines continues to put pressure on Canadian public drug plans

News release

January 31, 2023 — Ottawa, ON — Patented Medicine Prices Review Board

A new Patented Medicine Prices Review Board (PMPRB) report finds that prescription drug expenditures by Canadian public drug plans increased by 4.2% in 2020-21, bringing annual spending to $12.3 billion. The use of higher-cost medicines has been the primary factor behind rising costs for the public plans over the past five years, and this pressure continues to build.

In 2020-21, high-cost drugs accounted for over one third of total drug costs and yet were only used by 2.5% of drug plan beneficiaries. The 10 highest-cost drugs reimbursed by the public drug plans were all rare disease treatments with annual treatment costs of over $200,000.

These findings were released today by the PMPRB in the eighth edition of CompassRx, an annual report published under the National Prescription Drug Utilization Information System (NPDUIS) research initiative. CompassRx provides insight into the factors driving prescription drug expenditures in select Canadian public drug plans. This edition focuses on the 2020-21 fiscal year.

The study includes all provincial public drug plans (with the exception of Quebec), as well as Yukon and the Non-Insured Health Benefits Program. These plans account for approximately one third of the total annual spending on prescription drugs in Canada. 

Quick facts

  • Prescription drug expenditures for the NPDUIS public drug plans grew by 4.2% in 2020/21, following a 3.7% increase in 2019/20.

  • Between 2015/16 and 2020/21, the total prescription drug expenditures for Canada’s public drug plans rose by $2.5 billion, for a compound annual growth rate of 5.6%.

  • Drug cost growth for the NPDUIS public plans in 2020/21 was primarily driven by a greater use of higher-cost drugs combined with a sizable increase in the volume of drugs used per patient.

  • Nearly 60% of the total drug costs in 2020/21 were attributable to just 7% of public drug plan beneficiaries. High-cost drugs, which were used by 2.5% of beneficiaries, accounted for more than one third of costs.

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